Organization
NORTHERN TIER COUNSELING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL DENAULT (CEO)
(570) 265-0100
Entity
Organization
Contact information
Practice address
420 STATE ST, TOWANDA, PA 18848-8795
(570) 265-0100
(570) 265-6741
Mailing address
24727 ROUTE 6 STE 2, TOWANDA, PA 18848-8257
(570) 265-0100
(570) 265-6741
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
226990
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000753722
HIGHMARK PROV#-PSYCHIATRY
PA
Enumeration date
03/15/2007
Last updated
07/21/2022
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